Interpretive Handbook

Test
81031 :
Synthetic Glucocorticoid Screen, Serum

Synthetic glucocorticoids are widely used and have important clinical utility both as anti-inflammatory and immunosuppressive agents. The medical use of these agents, as well as their surreptitious use, can sometimes lead to a confusing clinical presentation. Patients exposed to these steroids may present with clinical features of Cushing syndrome, but with suppressed cortisol levels and evidence of hypothalamus-pituitary-adrenal axis suppression.

The presence of synthetic glucocorticoids in serum indicates current or recent use of these compounds. Since several of these compounds exceed the potency of endogenous cortisol by 1 or more orders of magnitude, even trace levels may be associated with Cushingoid features.

This method cannot detect the presence of fluticasone propionate in serum. Fluticasone propionate is quickly metabolized to fluticasone 17-beta carboxylic acid in urine. To screen for this metabolite, order 17BFP / Fluticasone 17-Beta-Carboxylic Acid, Urine.

This method cannot detect all of the available synthetic steroids either available as pharmaceutical compounds or chemicals present in food. The assay confirms only the listed synthetic glucocorticoids. (See Interpretation)

Lack of detection does not preclude use of synthetic glucocorticoids because adrenal suppression may persist for some time after the exogenous steroid is discontinued.